Looking from Canada to the United States, across Niagara's Horseshoe Falls

Friday, August 29, 2008

What will Dr. Kitts do to St. Kitts?

The Ottawa Citizen wrote in “All doctors are not equal” (Aug.27, 2008):

“A smart man like Dr. Jack Kitts should know better than to think he can sell patients the fiction that all surgeons are basically the same.As chief executive of The Ottawa Hospital, Dr. Kitts surely knows better than anyone that, as in any occupation, some physicians are more talented and competent than others. Dr. Kitts presumably knows which physicians at his hospital have had substance abuse problems; he knows which ones have terrible bedside manners; he knows which ones have been sued for malpractice. Dr. Kitts knows which surgeons he would never, ever allow to operate on a member of his own family.And yet, if he and other health-care officials have their way, the rest of us will have to settle for whichever surgeon is assigned to us.The proposed plan is known as the "single-queue system," and under this system surgery patients have no say on which surgeon gets their case. "You'll get into the line like you would at the bank where you take the next available teller, except it's the next available surgeon," Dr. Kitts explained.The way it works now, patients have more control than that. For example, patients typically consult with their family doctors, who as health-care insiders can give patients the scoop on which surgeons to seek out and which to avoid. The surgeons with good reputations get booked up and the ones with lesser reputations don't.Health-care officials are right to fear that this results in inefficiencies -- a disequilibrium in the system, so to speak. But removing consumer choice is not the way to fix it. Imagine what would happen if the government decided it's unfair that good car mechanics and good home renovators are busier than lousy ones, and so from now on the work will be evenly distributed. We'd have a lot of poorly repaired cars breaking down on the highway, and a lot of houses with leaks in the roof.Of course the government would never interfere this way in the car repair or home renovation business. It's bizarre to think that consumers will have more power to determine who gets to re-shingle their roof than who gets to remove their brain tumour.Dr. Kitts grudgingly admits that "there's a sense" by patients that some surgeons are better than others, and he says he'd like to change that perception. But he won't get very far if he's suggesting that patients are mistaken to believe such things.It's well known that a doctor's individual skill level can make the difference between a good and bad outcome. Some gastroenterologists are more likely than others to miss a cancerous lesion when scoping your colon. Some obstetricians are more likely than others to accidentally cause miscarriage while performing amniocentesis. Some plastic surgeons do a better job reconstructing diseased breasts than others.The medical research is very clear, for example, that a physician's skill in performing a procedure is related to the number of times he or she has done it, which is why experts always advise patients to ask about their doctor's experience. This is common sense, and something every informed patient ought to do.If the only way officials such as Dr. Kitts can make Canadian health care work is by removing consumer choice and obliterating the merit principle, then heaven help anyone who has the misfortune of needing an operation.”

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And this is the person now leading the charge to consolidate the Niagara Health System?

This is the future of St. Catharines Liberal MPP Jim Bradley’s health-care monopoly: a “single queue system”, where there is even less patient choice?!

Get whatever doctor you’re lucky enough to get, and be thankful for it, at that??

Are we to line up for operations like we now do at the coffee shop and get whatever server happens to be next? Is that the future of the medicare monopoly health-system that Good Ole Jim Bradley so thunderously supported for thirty years?

Unbelievable. Flicking unbelievable.

The “dis-equilibrium’ we need to look at is rooted in the Liberal’s Commitment To the Future of Medicare Act. This is where the Liberal's ideological authoritarianism is displayed.

Jim Bradley and his Liberals have been enemies of the health care consumer for years, demonizing private insurance and two-tier, parallel health care options for patients.

'Making healthcare work by removing patient choice' has been Bradley's trade-mark for decades.